{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T16:50:23Z","timestamp":1778863823838,"version":"3.51.4"},"reference-count":9,"publisher":"SMC Media","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0Accessory spleen, or splenunculus, is a congenital anomaly resulting from failure of splenic anlage fusion during embryonic development. It is most commonly located near the splenic hilum or pancreatic tail and rarely occurs within the stomach wall. Gastric accessory spleen is a rare entity that may mimic submucosal neoplasms such as gastrointestinal stromal tumour, posing a diagnostic challenge. Case presentation:\u00a0We report the case of a 37-year-old male presenting with a 3-month history of epigastric pain, dyspepsia, and nausea. Endoscopy revealed a 2.5\u20133 cm submucosal mass in the gastric fundus with intact mucosa, and erosive antral gastritis. Endoscopic ultrasound demonstrated a 22.6 \u00d7 17.2 \u00d7 23.3 mm hypoechoic, homogeneous lesion arising from the third layer of the gastric wall. Endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) showed lymphoid aggregates with characteristic vascular structures lined by CD8-positive littoral cells and CD68\/PGM1-positive macrophages. Immunohistochemistry excluded epithelial, neuroendocrine, and lymphoproliferative neoplasms, confirming the diagnosis of gastric accessory spleen. Discussion:\u00a0This case is distinctive because the patient had no prior splenectomy or trauma and was diagnosed preoperatively using EUS-guided biopsy\u2014avoiding unnecessary surgery. Gastric accessory spleen remains a rare but important differential diagnosis for submucosal gastric lesions. Recognition of its imaging and histopathologic features can prevent misdiagnosis and overtreatment. Conclusion:\u00a0Gastric accessory spleen is a benign, rare condition that should be considered in patients presenting with gastric submucosal masses. Non-invasive diagnostic modalities such as EUS-FNB and immunohistochemistry are essential to achieve an accurate diagnosis and to avoid unnecessary surgical resection.<\/jats:p>","DOI":"10.12890\/2025_005988","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T15:17:22Z","timestamp":1766157442000},"source":"Crossref","is-referenced-by-count":1,"title":["A rare case of splenunculus buried within the stomach"],"prefix":"10.12890","volume":"13","author":[{"given":"Mazen","family":"Farhat","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, St George University of Beirut, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karam","family":"Karam","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University of Balamand, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Attieh","sequence":"first","affiliation":[{"name":"Department of General Surgery, University of Balamand, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elie","family":"Mina","sequence":"first","affiliation":[{"name":"Department of Pathology, St George University of Beirut, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zarouhie","family":"Meguerian","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, St George University of Beirut, Beirut, Lebanon; Department of Pathology, St George University of Beirut, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elias","family":"Fiani","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, St George University of Beirut, Beirut, Lebanon; Department of Gastroenterology and Hepatology, University of Balamand, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ihab I.","family":"El Hajj","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, St George University of Beirut, Beirut, Lebanon; Department of Gastroenterology and Hepatology, University of Balamand, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10397","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"key":"10.12890\/2025_005988_ref1","doi-asserted-by":"crossref","unstructured":"Trujillo SG, Saleh S, Burkholder R, Shibli F, Shah B. Accessory Spleen: A Rare and Incidental Finding in the Stomach Wall. Cureus 2022;14:e24977. doi: 10.7759\/cureus.24977","DOI":"10.7759\/cureus.24977"},{"key":"10.12890\/2025_005988_ref2","doi-asserted-by":"crossref","unstructured":"Mohammadi S, Hedjazi A, Sajjadian M, Ghrobi N, Moghadam MD, Mohammadi M. Accessory Spleen in the Splenic Hilum: a Cadaveric Study with Clinical Significance. Med Arch 2016;70:389-391. doi: 10.5455\/medarh.2016.70.389-391","DOI":"10.5455\/medarh.2016.70.389-391"},{"key":"10.12890\/2025_005988_ref3","doi-asserted-by":"crossref","unstructured":"Almazeedi S, Alhaddad E, Al-Khithr T, Alhunaidi M. Incidental gastric accessory spleen during laparoscopic sleeve gastrectomy. Int J Surg Case Rep 2017;36:119-121. doi: 10.1016\/j.ijscr.2017.05.022","DOI":"10.1016\/j.ijscr.2017.05.022"},{"key":"10.12890\/2025_005988_ref4","doi-asserted-by":"crossref","unstructured":"Chen G, Nie L, Zhang T. An extremely rare case of a gastric accessory spleen: case report and review of the literature. BMC Gastroenterol 2021;21:275. doi: 10.1186\/s12876-021-01852-z","DOI":"10.1186\/s12876-021-01852-z"},{"key":"10.12890\/2025_005988_ref5","doi-asserted-by":"crossref","unstructured":"Kim JS, Chong A, Kim SM. Diagnosis of gastric subepithelial mass as an accessory spleen using fusion of spleen SPECT and CT images. Radiol Case Rep 2018;13:1137-1140. doi: 10.1016\/j.radcr.2018.07.021","DOI":"10.1016\/j.radcr.2018.07.021"},{"key":"10.12890\/2025_005988_ref6","doi-asserted-by":"crossref","unstructured":"Hou S, Cheng B, Gao Z, Ye Y. Congenital accessory spleen in the fundus of stomach mimicking a gastrointestinal stromal tumor. Asian J Surg 2023;46:1585-1586. doi: 10.1016\/j.asjsur.2022.09.147","DOI":"10.1016\/j.asjsur.2022.09.147"},{"key":"10.12890\/2025_005988_ref7","doi-asserted-by":"crossref","unstructured":"Shen YT, Zhou CH, Tang W, Wu W, Chen GQ, Hu DM. Accessory Spleen Presenting as a Submucosal Lesion on Stomach Wall after Splenectomy. Chin Med J (Engl) 2018;131:869-870. doi: 10.4103\/0366-6999.228240","DOI":"10.4103\/0366-6999.228240"},{"key":"10.12890\/2025_005988_ref8","doi-asserted-by":"crossref","unstructured":"Zhang J, Zhong JW, Lu GR, Zhou YH, Xue ZX, Ye MS. Accessory spleen originating from the intrinsic muscularis of the stomach misdiagnosed as gastrointestinal stromal tumor: a case report. J Int Med Res 2020;48:300060520935304. doi: 10.1177\/0300060520935304","DOI":"10.1177\/0300060520935304"},{"key":"10.12890\/2025_005988_ref9","doi-asserted-by":"crossref","unstructured":"Liu Y, Dai Y, Xiao F, Liu S, Wu Y, Ran E. Rare case of upper gastrointestinal hemorrhage due to accessory spleen: A case report. Medicine (Baltimore) 2022;101:e29636. doi: 10.1097\/MD.0000000000029636","DOI":"10.1097\/MD.0000000000029636"}],"container-title":["European Journal of Case Reports in Internal Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/5988\/5019","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/5988\/5020","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/5988\/5020","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T13:52:39Z","timestamp":1767966759000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/view\/5988"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,19]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.12890\/2025_005988","relation":{"has-manifestation":[{"id-type":"other","id":"1-133-5988-g5019","asserted-by":"subject"},{"id-type":"other","id":"1-133-5988-g5020","asserted-by":"subject"}],"is-part-of":[{"id-type":"other","id":"1-133","asserted-by":"subject"}]},"ISSN":["2284-2594"],"issn-type":[{"value":"2284-2594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,19]]}}}